Category: Statistics

Open Forum Infect Dis. 2023 Oct 27;10(11):ofad515. doi: 10.1093/ofid/ofad515. eCollection 2023 Nov.

ABSTRACT

BACKGROUND: Neurological opportunistic infections cause significant morbidity and mortality in people with human immunodeficiency virus (HIV) but are difficult to diagnose.

METHODS: One hundred forty people with HIV with acute neurological symptoms from Iquitos, Peru, were evaluated for cerebral toxoplasmosis with quantitative polymerase chain reaction (qPCR) of cerebrospinal fluid (CSF) and for cryptococcal meningitis with cryptococcal antigen test (CrAg) in serum or CSF. Differences between groups were assessed with standard statistical methods. A subset of samples was evaluated by metagenomic next-generation sequencing (mNGS) of CSF to compare standard diagnostics and identify additional diagnoses.

RESULTS: Twenty-seven participants were diagnosed with cerebral toxoplasmosis by qPCR and 13 with cryptococcal meningitis by CrAg. Compared to participants without cerebral toxoplasmosis, abnormal Glasgow Coma Scale score (P = .05), unilateral focal motor signs (P = .01), positive Babinski reflex (P = .01), and multiple lesions on head computed tomography (CT) (P = .002) were associated with cerebral toxoplasmosis. Photophobia (P = .03) and absence of lesions on head CT (P = .02) were associated with cryptococcal meningitis. mNGS of 42 samples identified 8 cases of cerebral toxoplasmosis, 7 cases of cryptococcal meningitis, 5 possible cases of tuberculous meningitis, and incidental detections of hepatitis B virus (n = 1) and pegivirus (n = 1). mNGS had a positive percentage agreement of 71% and a negative percentage agreement of 91% with qPCR for T gondii. mNGS had a sensitivity of 78% and specificity of 100% for Cryptococcus diagnosis.

CONCLUSIONS: An infection was diagnosed by any method in only 34% of participants, demonstrating the challenges of diagnosing neurological opportunistic infections in this population and highlighting the need for broader, more sensitive diagnostic tests for central nervous system infections.

PMID:37965640 | PMC:PMC10642733 | DOI:10.1093/ofid/ofad515

Data Brief. 2023 Oct 24;51:109723. doi: 10.1016/j.dib.2023.109723. eCollection 2023 Dec.

ABSTRACT

This dataset was created with the primary objective of elucidating the intricate relationship between the incidence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) re-infections and the pre-illness vaccination profile and types concerning alterations in sports-related physical activity (PA) after SARS-CoV-2 infection among adults. A secondary objective encompassed a comprehensive statistical analysis to explore the influence of three key factors-namely, Vaccination profile, Vaccination types, and Incidence of SARS-CoV-2 re-infections-on changes in PA related to exercise and sports, recorded at two distinct time points: one to two weeks prior to infection and one month after the last SARS-CoV-2 infection. The sample population (n = 5829), drawn from Hellenic territory, adhered to self-inclusion and exclusion criteria. Data collection spanned from February to March 2023 (a two-month period), involving the utilization of the Active-Q (an online, interactive questionnaire) to automatically assess weekly habitual sports-related PA among adults both before and after their last SARS-CoV-2 infection. The questionnaire also captured participant characteristics, pre-illness vaccination statuses (i.e., unvaccinated, partially vaccinated, fully vaccinated, and vaccine types), and occurrences of SARS-CoV-2 re-infections. The dataset sheds light on two noteworthy phenomena: (i) the intricate interplay between post-acute SARS-CoV-2 infection and a decline in sports-related physical activity (-27.6 ± 0.6%, 95%CI: -26.1 – -29.1), influenced by the pre-illness vaccination profile factor (p = 0.040); and (ii) the divergence in sports-related physical activity decline between partially vaccinated (-38.2 ± 0.7%, 95%CI: -35.3 – -41.1, p = 0.031) and fully vaccinated respondents (-19.2 ± 0.5%, 95%CI: -17.2 – -21.2). These phenomena underscore the imperative for tailored interventions and further investigation to promote the resumption of physical activity and mitigate long-term repercussions. Furthermore, this dataset enriches our understanding of the dynamics of sports-related physical activity and provides valuable insights for public health initiatives aiming to address the consequences of COVID-19 on sports-related physical activity levels. Consequently, this cross-sectional dataset is amenable to a diverse array of analytical methodologies, including univariate and multivariate analyses, and holds potential relevance for researchers, leaders in the sports and medical sectors, and policymakers, all of whom share a vested interest in fostering initiatives directed at reinstating physical activity and mitigating the enduring ramifications of post-acute SARS-CoV-2 infection.

PMID:37965614 | PMC:PMC10641141 | DOI:10.1016/j.dib.2023.109723

Data Brief. 2023 Oct 28;51:109733. doi: 10.1016/j.dib.2023.109733. eCollection 2023 Dec.

ABSTRACT

This work presents a substantial compilation of ground deformation maps portraying the dynamic evolution of the Valley of Toluca (VT) in Mexico. The dataset comprises a repository of 1121 BEAM-DIMAP formated maps obtained by the Differential Interferometric Synthetic Aperture Radar (DInSAR) technique. Leveraging satellite image pairs from the Sentinel 1-A and Sentinel 1-B satellites, the dataset spans intervals of 1, 3, 6, and 12 months between each image acquisition and covers a panoramic timeframe from October 2014 to December 2022. This compilation provides an in-depth chronicle of the VT’s ground transformations over a span of eight years that could be of interest to various disciplines. To enhance the dataset’s robustness, a supplementary comma-separated values (CSV) dataset includes the coherence statistics from the satellite image pairs, substantiating the precision and dependability of the ground deformation maps presented herein.

PMID:37965593 | PMC:PMC10641146 | DOI:10.1016/j.dib.2023.109733

Front Reprod Health. 2023 Oct 30;5:1270419. doi: 10.3389/frph.2023.1270419. eCollection 2023.

ABSTRACT

INTRODUCTION: The COVID-19 pandemic greatly impacted HIV prevention and care globally. The pandemic also had disproportionate impacts on the financial, emotional, and physical wellbeing of women and girls in East and Southern Africa, who were already at increased HIV vulnerability. This study aimed to understand how the COVID-19 pandemic and its response efforts impacted the sexual behavior, HIV prevention interest, general healthcare access, and other HIV risk factors of women and girls in HIV prevention studies.

METHODS: Using the socio-ecological model (SEM), an explanatory sequential mixed-methods analysis was performed with data from four Microbicide Trial Network (MTN) studies on different populations-adolescent girls and young women (AGYW), pregnant persons, breastfeeding persons, and couples-in Malawi, South Africa, Uganda, and Zimbabwe. Descriptive statistics for outcomes of interest were calculated within each study separately and Chi-squared tests of independence were performed to evaluate associations between study population and outcomes. Excerpts from study qualitative interviews were stratified into code reports which were then summarized into memos with key themes and considerations of the SEM framework to provide context to quantitative findings.

RESULTS: Few participants (8/731) had known or suspected COVID-19 infection. Sexual frequency and alcohol use decreased most often among AGYW compared to pregnant or breastfeeding women and couples (p-value < 0.001). The pandemic had little impact on changes in reported HIV prevention interest or access to HIV prevention study products. Healthcare access was impacted for everyone, with couples most likely to report decreases in access (p-value < 0.001). From qualitative interviews, economic instability, adverse mental health, and increased violence due to COVID-19 caused increased strain on other factors related to HIV vulnerability.

CONCLUSIONS: While interest in HIV prevention did not change and a few HIV risks decreased for most women and girls, other vulnerabilities to HIV increased due to the COVID-19 pandemic, highlighting the importance of continued access to HIV prevention for women and girls. More research is needed to better understand the long-term impact of COVID-19 on HIV prevention and vulnerability in community populations.

PMID:37965588 | PMC:PMC10642282 | DOI:10.3389/frph.2023.1270419

Med Cannabis Cannabinoids. 2023 Nov 13;6(1):160-169. doi: 10.1159/000534710. eCollection 2023 Jan-Dec.

ABSTRACT

INTRODUCTION: Post-traumatic stress disorder (PTSD) is a debilitating disorder experienced by a subgroup of individuals following a life-threatening trauma. Several US states have passed laws permitting the medical use of marijuana (MMJ) by individuals with PTSD, despite very little scientific indication on the appropriateness of marijuana as a therapy for PTSD. This prospective pilot study of adults with confirmed PTSD in Florida (FL) investigated whether PTSD symptoms, sleep quality, affect, and general physical and mental health/well-being improved post-initiation of MMJ treatment.

METHODS: Participants, N = 15, were recruited from two MMJ clinics in Gainesville and Jacksonville, FL. To be eligible, participants had to be 18 years of age or older, not currently on MMJ, and willing to abstain from recreational marijuana, if using any, until the State Medical Cannabis Card was obtained, screen positive for PTSD. Participants were assessed at baseline (pre-MMJ initiation) and 30 and 70 days post-MMJ initiation using the Pittsburgh Sleep Quality Index (PSQI), PTSD Checklist for DSM-5 (PCL-5), Positive and Negative Affect Schedule (PANAS), PROMIS Global Health V1.2, and semi-structured marijuana and other substance use assessment.

RESULTS: PTSD symptom severity as measured by total PCL-5 score improved significantly at 30- and 70-day follow-ups. Similarly, statistically significant reductions in nightmares were reported at 30- and 70-day follow-ups. Corresponding improvements in sleep were noticed with participants reporting increased duration of sleep hours, sleep quality, sleep efficiency, and total PSQI score. Likewise, negative affect and global mental health improved significantly at follow-up. According to the post hoc analyses, the most statistically significant changes occurred between baseline and 30-day follow-up. The exception to this pattern was nightmares, which did not show significant improvement until day 70.

CONCLUSION: The findings of this study highlight the potential of MMJ in improving patient outcomes for those with PTSD, particularly concerning sleep disturbances, which often do not respond to currently available treatments.

PMID:37965569 | PMC:PMC10642978 | DOI:10.1159/000534710

Eur J Med Res. 2023 Nov 15;28(1):512. doi: 10.1186/s40001-023-01476-x.

ABSTRACT

OBJECTIVE: The traditional treatment of rheumatoid arthritis (RA) has some side effects. We aimed to explore the effect of metformin treatment on the expression of HMGB1, cytokines, T cell subtypes and the clinical outcomes in RA patients.

METHODS: The present prospective cohort study recruited 124 RA patients (metformin group) who were treated with metformin and conventional therapy (methotrexate, hydroxychloroquine sulfate and sulfasalazine) and 98 RA patients (conventional therapy group) who were only treated with conventional therapy. All subjects were admitted from December 2018 to December 2021 and continuous medication for 90 days. The serum high mobility group box 1 (HMGB1), tumor necrosis factor α (TNF-α), interleukin (IL)-6, IL-1β and C-reactive protein (CRP) levels were measured by enzyme-linked immunosorbent assay (ELISA). Flow cytometric were used to analyze the expression of CD4⁺ and CD8⁺. Demographic and clinical statistics including age, body mass index (BMI), sex, course of disease, erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), visual analogue score (VAS)and disease activity score (DAS)-28 were collected.

RESULTS: The serum levels of HMGB1, CRP, IL-6, CD4+ expression and CD4+/CD8+ ratio were significantly increased in patients with DAS-28 score ≥ 2.6. The serum HMGB1 and cytokines levels of metformin group declined more quickly during the study time. Pearson’s analysis supported that a positive correlation existed between the HMGB1 and IL-6, TNF-α, CRP, CD4⁺, CD4⁺/CD8⁺ ratio, and VAS scores. HMGB1 could be a potential diagnostic biomarker for RA patients in active phase. Serum HMGB1 (95% CI 1.133-1.397, P < 0.001) was a factor associated with active RA.

CONCLUSION: The serum HMGB1 levels were significantly increased in RA patients in active phase. The serum levels of HMGB1 and inflammatory factors and VAS scores were decreased gradually with metformin treatment. HMGB1 might act as a novel therapeutic target for RA.

PMID:37964313 | DOI:10.1186/s40001-023-01476-x

J Cardiothorac Surg. 2023 Nov 14;18(1):323. doi: 10.1186/s13019-023-02448-2.

ABSTRACT

OBJECTIVE: We designed a simplified total arch reconstruction (s-TAR) technique which could be performed under mild hypothermia (30-32 °C) with distal aortic perfusion. This study aimed to compare its efficacy of organ protection with the conventional total arch reconstruction (c-TAR).

METHODS: We reviewed the clinical data of 195 patients who had ascending aortic aneurysm with extended aortic arch dilation and underwent simultaneous ascending aorta replacement and TAR procedure between January 2018 and December 2022 in our center. 105 received c-TAR under moderate hypothermia (25-28 °C) with circulatory arrest (c-TAR group); rest 90 received s-TAR under mild hypothermia (30-32 °C) with distal aortic perfusion (s-TAR group).

RESULTS: The s-TAR group demonstrated shorter CPB time, cross-clamp time and lower body circulatory arrest time compared with the c-TAR group. The 30-day mortality was 2.9% for the c-TAR group and 1.1% for the s-TAR group (P = 0.043). The mean duration of mechanical ventilation was shorter in the s-TAR group. Paraplegia was observed in 4 of 105 patients (3.8%) in the c-TAR group, while no such events were observed in the s-TAR group. The incidence of temporary neurologic dysfunction was significantly higher in the c-TAR group. The incidence of permanent neurologic dysfunction also showed a tendency to be higher in the c-TAR group, without statistical significance. Furthermore, the incidence of reoperation for bleeding were significantly lower in the s-TAR group. The rate of postoperative hepatic dysfunction and all grades of AKI was remarkably lower in the s-TAR group. The 3-year survival rate was 95.6% in the s-TAR group and 91.4% in the c-TAR group.

CONCLUSIONS: s-TAR under mild hypothermia (30-32℃) with distal aortic perfusion is associated with lower mortality and morbidity, offering better neurological and visceral organ protection compared with c-TAR.

PMID:37964308 | DOI:10.1186/s13019-023-02448-2

BMC Med. 2023 Nov 14;21(1):438. doi: 10.1186/s12916-023-03152-7.

ABSTRACT

BACKGROUND: Breast cancer is the most commonly diagnosed cancer in women worldwide, and underlying mechanistic pathways associated with breast cancer-specific and non-breast cancer-related deaths are of importance. Emerging evidence suggests a role of oxysterols, derivates of cholesterol, in multiple chronic diseases including breast cancer and coronary artery diseases. However, associations between oxysterols and survival have been minimally studied in women diagnosed with breast cancer. In this large breast cancer patient cohort, we evaluated associations between a panel of circulating oxysterols and mortality and recurrence outcomes.

METHODS: Concentrations of 13 circulating oxysterols representing different pathways of cholesterol metabolism were quantified using liquid-chromatography mass-spectrometry. Associations between baseline levels of oxysterols and cause-specific mortality outcomes and recurrence following a breast cancer diagnosis were assessed in 2282 women from the MARIE study over a median follow-up time of 11 years. We calculated hazard ratios (HR) and 95% confidence intervals (CI) using multivariable Cox proportional hazard models and competing risks models.

RESULTS: We observed no associations for circulating oxysterols and breast cancer-specific outcomes. Higher levels of six oxysterols were associated with an increased risk of cardiovascular disease death, including 24S-hydroxycholesterol (alternative bile acid pathway, HR_log2 = 1.73 (1.02, 2.93)), lanosterol (cholesterol biosynthesis pathway, HR_log2 = 1.95 (1.34, 2.83)), 7-ketocholesterol (HR_log2 = 1.26 (1.03, 1.55)), 5α,6α-epoxycholesterol (HR_log2 = 1.34 (1.02-1.77)), and 5a,6β-dihydroxycholestanol (HR_log2 = 1.34 (1.03, 1.76)). After adjusting for multiple comparisons, none of the associations were statistically significant.

CONCLUSION: We provide first evidence on a range of circulating oxysterols and mortality following a breast cancer diagnosis, contributing to a better understanding of associations between different pathways of cholesterol metabolism and prognosis in women with a breast cancer diagnosis. The findings of this study suggest circulating oxysterols may be associated with cardiovascular mortality among women diagnosed with breast cancer. Further studies are needed to evaluate these oxysterols as potential markers of risk for cardiovascular mortality among women with a breast cancer diagnosis as well as their clinical potential.

PMID:37964298 | DOI:10.1186/s12916-023-03152-7

J Cardiothorac Surg. 2023 Nov 14;18(1):330. doi: 10.1186/s13019-023-02435-7.

ABSTRACT

BACKGROUND: Pulmonary carcinoid is a rare diagnosis with surgery remaining the standard treatment of choice. However, resection may impact patients’ daily activities due to decreased lung volume reserve and postoperative pain. Our study aims to compare the impact of different types of surgical resection on the post-operative quality of life with the application of a strict peri-operative pulmonary care program.

METHODS: Patients who underwent surgery for bronchopulmonary carcinoid tumors in a tertiary cancer center between August, 2017 and March, 2020 were identified and demographic data was collected. Patients were contacted via phone for the qualitative and quantitative assessment of pain and quality of life, utilizing the Arabic version of Short-form McGill Pain Questionnaire and Activity of Daily Living (ADL) instrument respectively. Lung reserve was assessed before and after surgery. Statistical analysis used Chi-Square for categorical variables and ANOVA for continuous variables.

RESULTS: A total of 16 patients underwent different type of resection. The majority were male (n = 10; 63%) with a mean age of 44 years (19-81). Most common clinical stage was stage I (n = 12, 75%) with typical carcinoid features recorded in more than half of the cases (n = 11, 69%). Almost all patients underwent surgical excision (n = 15, 94%) with negative resection margin and no major post-operative complications. Bilobectomy was the most frequent procedure (n = 6, 40%) and video-assisted thoracoscopic surgery (VATS) was utilized in 8 patients (50%). Expected changes were recorded in pre- and postoperative pulmonary function test with an average drop of 10 in FEV1 and 14 mL/min/mmHg in DLCO. The majority of patients (n = 15, 94%) were totally independent doing daily activities. Mild intermittent pain was found in 7 patients (44%) who scored an average intensity of 1.6 out of 10.

CONCLUSIONS: Excellent long-term outcomes can be achieved following surgical resection of pulmonary carcinoid tumors with little to no effect on patients’ lung function and quality of life in regard to performance status and post-operative pain when a good peri-operative pulmonary, physical rehabilitation, and pain management programs are adopted and strictly implemented.

PMID:37964297 | DOI:10.1186/s13019-023-02435-7

BMC Oral Health. 2023 Nov 14;23(1):865. doi: 10.1186/s12903-023-03585-9.

ABSTRACT

BACKGROUND: In dentistry, nosocomial infection poses a great challenge to clinicians. The microbial contamination of water in dental unit waterlines (DUWLs) is ubiquitous. Such infected DUWLs can transmit oral microbes in the form of aerosols. Previous studies have suggested treating DUWLs with various disinfectants to reduce cross-contamination. The literature lacks a comparative evaluation of the effect of the use of 0.2% chlorhexidine (CHX) and 0.1% sodium hypochlorite (NaOCl) in DUWLs on aerosolized bacteria generated during dental procedures.

OBJECTIVE: To compare the effect of NaOCl and CHX in DUWLs on aerosolized bacteria generated during restorative and endodontic procedures.

MATERIALS AND METHODS: A total of 132 patients were equally divided into three groups (n = 44 in each group) according to the content of DUWL as follows. Group I-0.1% NaOCl Group II-0.2% CHX Group III-distilled water (Positive control) One-way ANOVA was performed and the Kruskal-Wallis test was used for intergroup comparison.

RESULTS: For the restorative procedure, inter-group comparison of mean colony-forming units (CFU) scores showed a statistically significant difference between the groups (p – .001) with the score of group 3 higher than group 2 followed by group 1. For the endodontics, an inter-group comparison of CFU scores showed a statistically significant difference between the groups (p – .003) with the mean score in group 1 being the lowest and group 3 being the highest.

CONCLUSION: The addition of NaOCl or CHX in DUWLs shows an effective reduction in aerosolized bacteria compared to distilled water.

PMID:37964280 | DOI:10.1186/s12903-023-03585-9